A Medical Ethics ROP Journey with Jayun Bae

Jayun Bae – ROP299Y 2016-17
My name is Jayun Bae and I am completing my second year in the Neuroscience and Bioethics majors at the University of Toronto, St. George. I was a 2016-2017 Research Opportunity Program (ROP) student in Dr. Pascal Tyrrell’s lab, working on a study that investigated the ethics of sharing patient data with private organizations (see my timeline above). I am a member of the Hart House Debating Club and an events associate for the Life Science Student Network. 
                                                               
My ROP project was necessitated by the partnership proposed by the Medical image Networking Enterprise (MiNE) that would establish a data-sharing relationship between public and private sector organizations. The ethical concerns with the partnership involved patient consent, privacy, and financial gain – but there were also issues that I
uncovered throughout the project. It quickly became clear that the answers could not be found through an examination of precedence or legal documents, because many of the research actions that would take place (specifically involving private organizations) fell in the grey area between what was legal and what was ethical. For example, the Personal Information Protection and Electronic Documents Act (PIPEDA) and Personal Health Information Protection Act (PHIPA) are two guidelines for organizations to follow when handling patient data – but neither are able to clearly and positively dictate how this partnership should operate.
Therefore, I developed a study that would seek expert opinions through the administration of a survey. I conducted interviews at Sunnybrook Health Sciences Centre and the University of Toronto and performed qualitative data analysis. My ROP project was presented at the ROP Poster Fair and the Victoria College Research Day events. The ROP was an extremely valuable experience in gaining research skills, and I’m grateful to
Dr. Tyrrell for the guidance and mentorship. The project is not yet completed, so I am looking forward to continuing the study beyond the scope of the ROP.   
Please have a look at my poster from the 2017 ROP Research Day below:

MRI, Statistics, Carotid Arteries, and 1000 Cups of Coffee with George Wang

GeorgeWang – ROP299Y 2016-17
I’m George. I have recently completed my 2nd year undergrad at the University of Toronto studying physiology and physics. In the fall-winter term of 2016-17 I had the privilege to work in Pascal’s group, looking into carotid artery MRI and using the volume of the carotid artery vessel wall as a marker for atherosclerosis. Having an acquired interest in medical imaging and a previous summer position working with PET, I saw this as an excellent opportunity to expand my knowledge of the field while having the chance to be exposed to clinical research methods. Above is my account of how the year went in a nutshell.
 
Have a look at my poster from the ROP Research Day below…
 
 

Dem Bones Dem Bones Dem Dry Bones

Happy Canadian Thanksgiving!!!

A traditional holiday – originating from the native peoples of the Americas – to celebrate the completion and bounty of the harvest.

This year I am off to Algonquin park for a canoe portage trip with the kids! I will take the time to appreciate some of the successes of our MiVIP program and this blog over the long weekend.

Thanks for being a part of it!

Listen to Dem Bones by the famous Delta Rhythm Boys

… and I’ll see you in the blogosphere.

Pascal Tyrrell

MRA Is More Cost-Effective than the Current Strategy for Testing > 70% Carotid Stenosis

ROP Research Forum March 5th, 2015 – Kevin Chen





Kevin Chen is a 2nd year research opportunity program student studying neuroscience and
physiology in the University of Toronto Life Sciences Program. His main goal is to get into
medical school and to enjoy the UofT experience as much as possible!

Kevin’s ROP project consisted
of cost effectiveness analysis modeling to explore whether MRA could be a
cost-effective measure in testing and treating patients with carotid stenosis.
Preliminary results showed that in a subset of the population at risk for
carotid stenosis (> 70 %), MRA was dominant over the current strategy of testing with
Doppler Ultrasound. By reducing MRA scan time and by tailoring MRA sequences we believe it possible to extend these findings to include a larger sub-population (> 50 %). More to follow…

Well done, Kevin!

See you in the blogosphere,

Pascal Tyrrell

Research Opportunity Program: Cost Effectiveness and Imaging Carotid Stenosis

ROP Research Forum March 5th, 2015 – Sylvia Urbanik

Sylvia is a second year student studying cell and molecular biology. She is currently finishing up her Research Opportunity Program that spanned the fall and winter semesters, and also recently represented us at the March 5th ROP research forum along with her partner and predecessors.

 
Her project dealt with cost-effectiveness analysis techniques for diagnostic imaging modalities, with a specific focus on carotid artery stenosis. She explored the different types of analyses used in assessing cost effectiveness. She examined how factors such as sensitivity and specificity of diagnostic tests (imaging modalities in this case) can affect the analysis, and conducted literature searches in order to find these variables in order to incorporate them into a cost effectiveness model.​

Well done, Sylvia!

Stay tuned, next Kevin Chen will be modeling with TreeAge…

See you in the blogosphere,

Pascal Tyrrell

Research Opportunity Program: Imaging Carotid Stenosis

ROP Research Forum March 5th, 2015 – Helena Lan

Helena is a second-year student pursuing a specialist in Pharmacology and Toxicology at the University of Toronto. Participating in ROP299 this past summer (see here) has opened many doors for her. She is currently assisting Pascal on a systematic review on research methodology and biostatistics in medical imaging, working as a research assistant for a medical education study, participating in the research abroad program at Karolinska Institutet this summer… and recently represented us at the March 5th, 2015 ROP research forum!

Helena examined the technical aspects and information provided by two major imaging modalities, MRI and ultrasound, for diagnosing carotid stenosis. She suggests that MRI holds great promise to serve as a cost effective test for carotid stenosis as well as a tool for assessing vessel health and plaque composition that would provide important information for patient management decisions.




Stay tuned, next Sylvia Urbanik will be talking about cost effectiveness…

See you in the blogosphere,

Pascal Tyrrell

Research Opportunity Program: What Is Carotid Stenosis and How Are We Treating Affected Patients?

ROP Research Forum March 5th, 2015 – Alana Man

Alana Man is a second year University of Toronto student pursuing a specialist in Bioinformatics and Computational Biology and a major in Immunology. She was a Research Opportunity student last summer with MiVIP (see here) and recently represented us at the March 5th, 2015 ROP research forum.

Alana’s project focused on care for patients with carotid stenosis in Toronto, Ontario, Canada. She looked at the different factors contributing to access to diagnostic testing such as procedure costs, wait times, and the differences between available imaging modalities and explores whether MRI could be the diagnostic test of choice over DUS for people at increased risk of carotid stenosis.

Well done, Alana!




Stay tuned, next Helena Lan will be comparing MRI and DUS…




See you in the blogosphere,




Pascal Tyrrell

Who is Going to the Karolinska Institute this Summer? Helena Lan Is, That’s Who!!!!










The Karolinska Institutet is one of the world’s leading medical universities and is located in Stockholm, Sweden. Did you know that in 1895 Alfred Nobel appointed the Karolinska Institutet to annually award the Nobel Prize in medicine or physiology? Now you do.

So, you may have read my previous post about “Connectory”. Well today I want to talk to you about one of my Research Opportunity Program students at the University of Toronto, Helena Lan. Not only was she a star student with me last summer (see her timeline post here) but she has continued on with our MiVIP group contributing to a systematic review on research methodology and biostatistics in medical imaging (stop rolling your eyes, it IS an interesting topic!).


Well she just found out that that she has been invited to work at the Karolinska Institute this summer as part of the Summer Research Abroad Program at the University of Toronto which is sponsored by the the Centre for International Experience. WOW!!!







Her supervisor will be Dr. Sofia Johansson, an assistant professor at Karolinska Institutet. Her research is focused on natural killer cell biology. You can find her research interests here.

Want to know about what natural killer cells do as part of our innate immune system? Watch this cool video.












Cool right? Well, I enjoyed it anyway. Maybe you need to watch Mr Brightside by The Killers to recover and…

… I’ll see you in the blogosphere.
PS: Congratulations Helena!!!

Pascal Tyrrell

Who’s in Agreement?

So, let’s say you have invited everyone over for the big game on Sunday (Superbowl 49) but you don’t have a big screen TV. Whoops! That sucks. Time to go shopping. Here’s the rub: which one to get? There are so many to chose from and only a little time to make the decision. Here is what you do:


1- call your best friends to help you out
2- make a list of all neighboring electronics stores 
3- Go shopping!


OK, that sounds like a good plan but it will take an enormous amount of time to perform this task all together and more importantly your Lada only seats 4 comfortably and you are 8 buddies.


As you are a new research scientist (see here for your story) and you have already studied the challenges of assessing agreement (see here for a refresher) you know that it is best for all raters to assess the same items of interest. This is called a fully crossed design. So in this case you and all of your friends will assess all the TVs of interest. You will then make a decision based on the ratings. Often, it is of interest to know and to quantify the degree of agreement between the raters – your friends in this case. This assessment is the inter-rater reliability (IRR). 


As a quick recap, 


Observed Scores = True Score + Measurement Error


And


Reliability = Var(True Score)/ Var(True Score) + Var(Measurement Error)


Fully crossed designs allow you to assess and control for any systematic bias between raters at the cost of an increase in the number of assessments made. 


The problem today is that you want to minimize the number of assessments made in order to save time and keep your buddies happy. What to do? Well, you will simply perform a study where different items will be rated by different subsets of raters. This is a “not fully crossed” design! 


However, you must be aware that with this type of design you are at risk of underestimating the true reliability and therefore must, therefore, perform alternative statistics.


I will not go into statistical detail (today anyway!) but if you are interested have a peek here. The purpose of today’s post was simply to bring to your attention that you need to be very careful when assessing agreement between raters when NOT performing a fully crossed design. The good news is that there is a way to estimate reliability when you are not able to have all raters assess all the same subjects.


Now you can have small groups of friends who can share the task of assessing TVs. This will result in less assessments, less time to complete the study, and – most importantly – less use of your precious Lada! 


Your main concern, as you are the one to make the purchase of the TV, is still: can you trust your friends assessment score of TVs you did not see? But now you have a way to determine if you and your friends are on the same page!




Maybe this will avoid you and your friends having to Agree to Disagree as did Will Ferrell in Anchorman…




Listen to an unreleased early song by Katy Perry Agree to Disagree, enjoy the Superbowl (and Katy Perry) on Sunday and…


…I’ll see you in the blogosphere!




Pascal Tyrrell

The story behind Connectory…

So, you are reading our blog thinking Pascal is a nut – that much is clear – but what of all the students plugged into his group? Are they nuts too?


Well maybe, but today I am going to talk to you about the group of four (not the group of seven) who started small and grew to be Connectory. John, Maria, Natasha, and Roger met in a graduate course at the University of Toronto and decided to work together on a project about innovation. That’s when they met me, joined “the program”, and got busy! Starting any endeavour from scratch is no easy task. All four had never met before, all came from very different academic backgrounds, and though their initial project was for “credit” the rest was on their own time.


There were some rough times at first but with perseverance comes success and Connectory was born and is just finishing up its first project as a new start-up business. Wow! 


Essentially Connectory is a data management solutions software development consulting group that operates in the healthcare space. Check out their webpage here.


Ok, so what? Well this post is not only to congratulate these four on a job well done but also to encourage you to do the same. One thing is for sure: if you don’t try you will not succeed – ever. My programs are all about learning, trying new stuff, benefiting from your successes as well as your failures, and wait for it… giving back. Yup as Uncle Ben said in Spiderman: “With great power comes great responsibility“. 


Just wanted to share a good story from our group with you today.




Listen to Bulletproof by La Roux to get pumped and…


… I’ll see you in the blogosphere!




Pascal Tyrrell